Biomaterial Database

The Contribution of Supplementary Tests in the Differential Diagnosis of Dementia. 2018

Fabiano Moulin de Moraes, and Paulo Ferreira Bertolucci

1 Service of Cognitive and Behavioral Neurology, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil.

BACKGROUND Supplementary tests are part of the clinical approach to diagnose cognitive impairment. We aimed to determine the role of supplementary examinations, except for biomarkers, on diagnostic stability of dementia over time and to identify reversible dementias. METHODS We identified 432 patients with dementia who performed 2 clinical evaluations and the supplementary examinations recommended by the American Academy of Neurology in a follow-up period of 1 year. RESULTS In this sample, 110 (24.5%) patients changed their diagnosis at 1-year follow-up for the appearance of vascular cognitive impairment than the initial diagnosis, due to the neuroimaging. Concerning the reversible dementias, depression was the major differential diagnosis, detected in 13 (81%) of the 16 patients with cognitive improvement. CONCLUSIONS Therefore, regarding the supplementary examinations only neuroimaging and the depression triage were relevant for clinical practice regarding the differential diagnosis of dementia.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D011237	Predictive Value of Tests	In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.	Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D003704	Dementia	An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness.	Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D003863	Depression	Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders.	Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D015140	Dementia, Vascular	An imprecise term referring to dementia associated with CEREBROVASCULAR DISORDERS, including CEREBRAL INFARCTION (single or multiple), and conditions associated with chronic BRAIN ISCHEMIA. Diffuse, cortical, and subcortical subtypes have been described. (From Gerontol Geriatr 1998 Feb;31(1):36-44)	Arteriosclerotic Dementia,Binswanger Disease,Encephalopathy, Binswanger,Leukoencephalopathy, Subcortical,Subcortical Arteriosclerotic Encephalopathy,Vascular Dementia,Acute Onset Vascular Dementia,Arteriosclerotic Encephalopathy, Subcortical,Binswanger Encephalopathy,Binswanger's Disease,Chronic Progressive Subcortical Encephalopathy,Encephalopathy, Binswanger's,Encephalopathy, Chronic Progressive Subcortical,Encephalopathy, Subcortical Arteriosclerotic,Encephalopathy, Subcortical, Chronic Progressive,Subcortical Encephalopathy, Chronic Progressive,Subcortical Leukoencephalopathy,Subcortical Vascular Dementia,Vascular Dementia, Acute Onset,Arteriosclerotic Dementias,Arteriosclerotic Encephalopathies, Subcortical,Binswanger's Encephalopathy,Binswangers Disease,Dementia, Arteriosclerotic,Dementia, Subcortical Vascular,Dementias, Arteriosclerotic,Dementias, Subcortical Vascular,Dementias, Vascular,Disease, Binswanger,Disease, Binswanger's,Encephalopathies, Subcortical Arteriosclerotic,Encephalopathy, Binswangers,Leukoencephalopathies, Subcortical,Subcortical Arteriosclerotic Encephalopathies,Subcortical Leukoencephalopathies,Subcortical Vascular Dementias,Vascular Dementia, Subcortical,Vascular Dementias,Vascular Dementias, Subcortical
D059906	Neuroimaging	Non-invasive methods of visualizing the CENTRAL NERVOUS SYSTEM, especially the brain, by various imaging modalities.	Brain Imaging,Imaging, Brain